Provider Demographics
NPI:1528458155
Name:HANLON, TINA D'ANNA
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:D'ANNA
Last Name:HANLON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 FLANDERS RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3102
Mailing Address - Country:US
Mailing Address - Phone:410-683-1444
Mailing Address - Fax:
Practice Address - Street 1:16 FLANDERS RIDGE CT
Practice Address - Street 2:
Practice Address - City:COCKEYSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21030-3102
Practice Address - Country:US
Practice Address - Phone:410-683-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-03
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDT01268183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician